Effect of preoperative autologous blood donation and intraoperative and postoperative blood recovery on homologous blood transfusion requirement in cementless total hip replacement operation

BACKGROUND: Blood transfusion is often necessary in operations for total hip replacement (THR). This study was done to investigate the efficacy of three different methods of autologous blood conservation and transfusion in patients undergoing primacy THR without cement. STUDY DESIGN: One hundred fifty-five patients with osteoarthritis underwent unilateral cementless THR using normotensive general anesthesia performed by a single surgeon. The patients were divided into four groups depending on which conservation method was used. Ten different demographic and hematologic parameters were recorded and analyzed by using analysis of the variance and multiple regression methods. RESULTS: All three methods were effective in reducing the need for homologous blood transfusions. The greatest benefit was realized when both preoperative autologous blood donation and intraoperative salvage using the Cell Saver were combined. The addition of postoperative salvage and retransfusion of wound drainage blood using the Solcotrans System did not significantly reduce further the chance of homologous blood transfusions. CONCLUSIONS: The data from this study were similar to previously published reports. Regression analysis confirmed the correlation among the different variables studied. We currently offer preoperative donation and intraoperative salvage with the Cell Saver to patients undergoing cementless total hip replacement.